Younger brother has AIDS and is very irregular in following his treatment, check-ups and so on. I know from experience that pushing him to be more diligent will no doubt result in the opposite reaction. My question is: do you have teenage patients and if you do, how do you encourage them to pursue treatment correctly. He believes he's invincible and I am very worried about him. He is in good shape and does not exhibit any symptoms. I'm grateful for that but I also suspect its fooling him into not appreciating the importance of being careful and preventive.........

Response from Dr. Feinberg

HIV+ adolescents are very tough, and your instincts are right about bugging him -- he'll just become oppositional. The ideal thing is for him to get his care from an adolescent medicine specialist that works with HIV+ young people. One way to find such expertise is to contact pediatric HIV experts in your locale and ask about the availability of an adolescent specialist who deals with HIV. You could also talk to the experts at the Women & Children Forum at the Body and get their suggestions.

Personally, I have found HIV+ teenagers and young adults a difficult group to work with (I am not an adolescent specialist, but we don't have any in my city). I try to be as supportive and non-judgmental as I can, and even if they are inconstant about their medical care, I keep the lines of communication open so that they feel comfortable about coming back. Treatment only works if the person accepts it and is comfortable with it, and for some people this is just going to take time.

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